Routledge Taylor & Francis Group 270 Madison...

This book is part of the Family Therapy and Counseling Series, edited by Jon Carlson.

RoutledgeTaylor & Francis Group270 Madison AvenueNew York, NY 10016

RoutledgeTaylor & Francis Group27 Church RoadHove, East Sussex BN3 2FA

© 2011 by Taylor and Francis Group, LLCRoutledge is an imprint of Taylor & Francis Group, an Informa business

Printed in the United States of America on acid-free paper10 9 8 7 6 5 4 3 2 1

International Standard Book Number: 978-0-415-80061-7 (Hardback)

For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organiza-tion that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged.

Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

Library of Congress Cataloging-in-Publication Data

Working with immigrant families : a practical guide for counselors / edited by Adam Zagelbaum and Jon Carlson.

p. cm. -- (The family therapy and counseling series)Includes bibliographical references and index.ISBN 978-0-415-80061-7 (hardcover : alk. paper)1. Cross-cultural counseling--United States. 2. Immigrant

families--Counseling of--United States. I. Zagelbaum, Adam. II. Carlson, Jon.

BF636.7.C76W67 2011158’.3086912--dc22 2010018617

Visit the Taylor & Francis Web site athttp://www.taylorandfrancis.com

and the Routledge Web site athttp://www.routledgementalhealth.com

http://www.routledgementalhealth.com/working-with-immigrant-families-9780415800617

http://www.copyright.com

http://www.copyright.com

http://www.copyright.com/

http://www.taylorandfrancis.com

http://www.routledgementalhealth.com


v

Contents

Series Editor’s Foreword ........................................................................... viiPreface ....................................................................................................... ixContributors ............................................................................................xiii

1 Orientation to Working With Immigrant Families .......................... 1ADAM ZAgELbAuM AND JON CARLSON

2 Theories of Acculturation and Cultural Identity ............................. 21IRENE LÓPEZ, ERNESTO R. ESCOTO, TyFFANI MONFORD-DENT, AND MARINA PRADO-STEIMAN

3 Theories of Family Therapy ............................................................. 39JuLIE SHuLMAN AND gARIMA LAMbA

4 Working With Hispanic/Latino(a) Immigrant Families ................. 59ADAM ZAgELbAuM

5 Working With European Immigrant Families ................................ 75gREgg KuEHL, ADAM ZAgELbAuM, AND JON CARLSON

6 Working With African Immigrant Families ................................. 103RObyN bRAMMER

7 Working With Asian Immigrant Families, Part I: Far East, Southeast Asia, and Pacific Islands ............................................... 121A. ZAIDy MOHDZAIN

8 Working With Asian Immigrant Families, Part II: South Asia ..... 137MALA MADATHIL

9 Working With Middle Eastern Immigrant Families ......................151NAJI AbI-HASHEM



vi ◾ Contents

10 Working With Australian Families: Invisible Immigrants ............181SALLy HuNTER

11 Immigrant Families From Regions With Emerging Research ...... 195ADAM ZAgELbAuM

12 Working With Intercultural Immigrant Families ..........................211DOLORES D. TARvER AND JOy K. HARDEN

13 The Future of Counseling Immigrants and Their Families ........... 229EvELyN RIvERA-MOSquERA, MARSHA MITCHELL-bLANKS, ERÉNDIRA LÓPEZ-gARCÍA, AND OMAR FATTAL

Appendix A: National Resources on Cultural Competence ................... 261

Appendix b: Practical guidelines for Mental Health Professionals Working With Immigrants ............................................... 267

Index ...................................................................................................... 269



121

7Chapter

Working With Asian Immigrant Families, Part I: Far East, Southeast Asia, and Pacific Islands

A. Zaidy MohdZain

The term Asian refers to those having origins of the native people of the Far East, Southeast Asia, and Indian subcontinent (U.S. Census Bureau, 2004b). The U.S. Census Bureau (2004b) included Cambodia, China, Bangladesh, Burma (now known as Myanmar), India, Indonesia, Japan, Laos, Korea, Malaysia, Pakistan, Philippines, Taiwan, Thailand, and Vietnam. Another common term used is Pacific Islander, which refers to those having origins in any original people of Hawaii, Guam, Samoa, or other Pacific Islands such as Fiji or Tahiti. Within the

ContentsDemographic Description ............................................................................ 122Immigration Experience ............................................................................... 124The Family ................................................................................................... 125Counseling Issues ......................................................................................... 128Issues for Counselors .................................................................................... 130References .................................................................................................... 133



122 ◾ A. Zaidy MohdZain

United States, it is common for these two groups to be lumped together, as the term often appears Asian and Pacific Islander. For the purpose of this chapter, we are referring to those immigrants whose ancestors or origins come from both the Asian continent and the Pacific Islands as Asian immigrants. The term Oriental is outdated, and many Asian American clients may perceive it as an insult or insensitive. They may in return view the counselors using the term as culturally uninformed, which jeopardizes the counselors’ own rapport-building efforts. A more acceptable term, Asian American, is represented by some 43 different eth-nic groups of people originated from a large geographic area. As a group, Asian Americans lack homogeneity, and there are large within-group differences as exemplified by the very concept of diversity (Kim, Yang, Atkinson, Wolfe, & Hong, 2001; U.S. Department of Health and Human Services, 2001).

Demographic DescriptionAccording to the U.S. Census Bureau, in March 2002, there were about 12.5 million Asian and Pacific Islanders who lived in the United States. This rep-resents some 4.4% of the total population (U.S. Census Bureau, 2003). In the United States, Asian Indian, Chinese, Filipinos, Korean, and Vietnamese together made up about 80% of the Asian American population. Chinese was the largest group, representing some 24% of the Asian American population, followed by Filipinos, Asian Indian, Vietnamese, and Korean. In terms of the location in which Asian Americans lived in the United States, the U.S. Census Bureau (2004b) stated that 51% of them lived in the West, 19% lived in the South, 12% lived in the Midwest, and 19% lived in the Northeast. Nearly 95% of all Asians lived in metropolitan areas, and some 76% of Asian Americans are foreign born. Asian Americans alone constitute more than a quarter of the foreign-born population in the United States (U.S. Census Bureau, 2004b; U.S. Department of Health and Human Services, 2001).

The Chinese were among the first Asians who came to the United States in the 1850s to build the transcontinental railroad or work in the gold mines, mainly in California. About at the same time period, Japanese came to work in the sugar plantations of Hawaii, and some moved on to California. They were followed by Koreans and Filipinos. Asian Indians started coming to the United States in the early 1900s. Vietnamese and other Southeast Asians came in the late 1970s; many of them had to flee their countries in the aftermath of the Vietnam War (U.S. Department of Health and Human Services, 2001).

Asian Americans, whether they are immigrants, refugees, or American born and have been in the United States for generations, are still struggling with rac-ism and discrimination issues. As an extreme example, this author was fortunate



Working With Asian Immigrant Families, Part I: East Asia ◾ 123

to run into Dr. Ronald Takaki, a renowned professor of multicultural education and best-selling author. He shared his personal experience of how some in his audience of public lectures came backstage to commend him on his ability to speak English with no foreign accent and the shock they had when he informed them that he is a sixth-generation American (R. Takaki, personal communica-tion, April 14, 1999). Perhaps it was because his physical appearance, look, and demeanor were exemplified as “Oriental.” The issues of having the feeling or per-ception of not being accepted as “full Americans” and continuing to be regarded as “foreigners” by society at large continue to play into the psychic of many Asian Americans to this day. Sue and Sue (2008) revealed the result of a survey of a representative sample of some 1,000 adults undertaken by the Committee of 100 to determine their attitudes toward Asian Americans. The dominant per-ception of adult Americans, as revealed by the survey about Chinese Americans, is that Chinese Americans would be more loyal to China than to the United States, with the examples of over half of the people surveyed believing that Chinese Americans would pass secret information to China, a quarter of the sample would disapprove someone in their family to marry an Asian American, and some 17% would be upset if Asian Americans moved into their neighbor-hood. Recognizing the institutional racism, the California legislature approved a bill on July 17, 2009, to apologize to the state’s Chinese American community for racist laws enacted as far back as 1849 (Liu, 2009).

However, on the flip side of the coin, Asian Americans are also hailed as a “model minority” in affirming and realizing the widely held concept of achieving the “American dream.” Kluger (2009) reported a presentation at the annual con-vention of the American Sociological Association in San Francisco of research by Jeffrey Timberlake of the University of Cincinnati and Rhys Williams of Loyola University Chicago who surveyed 2,100 Ohioans to gauge the overall public perception of immigrants. The results indicated that Asians were uniformly ranked first in the wealth, intelligence, and self-sufficiency categories relative to Europeans, Middle Easterners, and Latinos. On average, Asian Americans when compared to any other ethnic group in the United States attain more education and have a higher proportion (45%) concentrated in managerial and professional specialty occupations, relative to 34% of the total population. The U.S. Census Bureau (2004b) stated that in 2000, 44% of Asian Americans aged 25 and older had a college or professional degree, compared to only 28% of the White popu-lation and 24% of the total population that had achieved that level of educa-tion. The census data in 1997 revealed that 58% of Americans who descended from natives of the Indian subcontinent had undergraduate, graduate, or profes-sional degrees (U.S. Department of Health and Human Services, 2001). Asian Americans are much more likely to earn a bachelor’s degree (51% compared to 32% of non-Hispanic Whites), and the U.S. Census Bureau (2003) reported




that in 2002, 87% of the 7.9 million Asian Americans aged 25 and older have earned at least a high school diploma. The average family income for Asian Americans tends to be higher than the national average. The median income of Asian families was over $9,000 higher than the median income for all families ($59,000 compared to $50,000) (U.S. Census Bureau, 2004b). Asian Indian and Japanese families’ median income were more than $10,000 higher than that of all Asian families, with Cambodian, Hmong, Korean, Laotian, Pakistanis, Thai, and Vietnamese family incomes substantially lower than the median for all Asian families. However, some subgroups of Asian Americans, namely, Hawaiian and other Pacific Islanders, Cambodian, Hmong, and Laotians, did not have high educational attainment, and the poverty rates for Asians is similar to those of total population, with Hmong having the highest individual poverty rates, followed by Cambodians (U.S. Census Bureau, 2004b). Therefore, as we look behind the success myth, there exists a wide variation in the economic attainment of Asian Americans as a group (Takaki, 1989; U.S. Department of Health and Human Services, 2001). This is a prime example of the danger of stereotyping, because 17% of Asian and Pacific Islander families had incomes of less than $25,000 compared to 15% of non-Hispanic Whites families, which in turn means that Asian and Pacific Islanders are more likely to live in poverty than non-Hispanic Whites.

Immigration ExperienceCounselors working with Asian immigrants need to be mindful that individual Asian immigrants may have different migration experiences. Chung, Bemak, Ortiz, and Sandoval-Perez (2008) stated that the immigration process itself is filled with a series of complex stressors that affect the mental health and quality of life of immigrant populations. Not all immigrants migrate voluntarily. The factors affecting their migration experiences may range from escaping the tyr-anny of a brutal regime for social and political security to seeking more freedom and economic and educational opportunities in the United States. The immi-grants’ experiences of coming to the United States can also be diverse. They range from immigrants having suffered a complete loss of all their possessions or a loss of close family members, to having to risk their life and witness their fellow refugees die in their attempts to escape oppressive regimes, to dealing with other horrific events. The traumatic journey can take its toll on the immigrants and their families, especially those without a social network of support. Regardless of their migration circumstances, they must adapt to survive and prosper in the new land. This adaptation process is often gradual and slow, and it forces the immigrants to cope with a set of different beliefs and behaviors in every facet




of their lives such as child rearing, family structure, gender roles, religious prac-tices, and others. These beliefs, behaviors, and lifestyles are often in sharp con-trast with their familiar cultural beliefs and behaviors. The adaptation process requires the immigrants to learn, understand, and internalize the new culture to the extent that it becomes familiar, controllable, and supportive.

Migrating from one country to another and learning how to adapt to the new place is much like being on a continuum with two extremes: enculturation and acculturation. Enculturation is a process of retaining one’s indigenous cul-tural values, behaviors, knowledge, and identity. Thus, those who are closer to this end of the continuum, that is, enculturation, are perceived to adhere more to Asian cultural values such as collectivism, conformity to the norms, defer-ence to authority figures, emotional restraint, filial piety, hierarchical family structure, and humility (Chung et al., 2008; Kim, Atkinson, & Yang, 1999; Sue & Sue 2008). The opposite or contrasting end of the spectrum is accul-turation, which is a process of adaptation to the dominant U.S. cultural norms. Thus, we see some Asian immigrants who completely identify with mainstream American culture, whereas others may develop adaptive bicultural identifica-tion that enables them to feel comfortable and functional within mainstream American culture as well as their culture of origin. Still there are those who continue to feel uncomfortable with life in the United States and instead choose to live and work exclusively within the confines of an ethnic enclave (Hong & Domokos-Cheng Ham, 2001; Sue & Sue, 2008). For the immigrant families, this transgenerational process takes each successive generation one step further toward acculturation, with the second generation usually being more accultur-ated than the first, and the third generation one step more acculturated than the previous two (Chung et al., 2008; Hong & Domokos-Cheng Ham, 2001). Kim and Omizo (2003) suggested that Asian Americans who strongly adhere to Asian cultural values tend to have less positive attitudes about seeking help and are less willing to see a counselor relative to those who do not adhere strongly to Asian cultural values. Kim, Ng, and Ahn (2009), however, concluded in their study of 61 Asian American clients at a counseling center at a large university on the West Coast that client adherence to Asian cultural values was not a signifi-cant predictor of counseling session outcome.

The FamilyGenerally, a dominant Asian cultural milieu is that of collectivism as opposed to individualism, a dominant cultural milieu in the United States. Collectivism emphasizes close family ties, hierarchy, and order as opposed to independence and autonomy of the individual. Asians’ concept of family and how they define




family may differ from that of counselors coming from mainstream American culture. The family relationships are often closer than those in mainstream American families. For instance, the concepts of being overly close or enmeshed or lacking boundaries may be interpreted differently by counselors from main-stream American culture than by their Asian immigrant families who come from an Asian cultural background. These two different frames of reference are what make it more challenging to counsel Asian immigrant families. For exam-ple, clients from Asian culture, especially those adhering very closely to Asian values, may exhibit interpersonal reliance and dependency. Although these may be considered healthy cultural norms in Asian culture, the same cannot be said in mainstream American culture. Counselors with a mainstream American cul-tural background who are not sufficiently knowledgeable of these cultural norms can easily and inadvertently diagnose Asian immigrants as having a dependent personality disorder (Chung et al., 2008). Another example of cultural norms is that first cousins are often viewed and presented as if they are siblings by Asian immigrants. It is a common experience or practice for cousins to grow up and be raised in the same household, typically cared for by the grandmother or eldest uncle or aunt. For some who are from a Muslim culture, the fact that two infants were breast-fed by the same woman makes them siblings for their entire lives. Thus, the worldview of Asian immigrants in terms of family relationships and whom they consider as members of their family may differ relative to main-stream Americans.

Asian immigrant families tend to be more hierarchical and patriarchal than mainstream American families (Hong & Domokos-Cheng Ham, 2001; Sue & Sue, 2008). Asian Americans are more likely to live in households that are com-posed exclusively of family members. In 2004, 76% of Asian Americans live in this family household arrangement compared to 67% of non-Hispanic White and African American households (U.S. Census Bureau, 2004a). They place more emphasis on the authority of parents over children and of the older sibling over younger siblings. Other than the fact that communication flows downward, the tradition dictates deference to the elders. For instance, a married son’s primary allegiance (family loyalty) remains with his parents, as opposed to the circum-stances in contemporary mainstream American culture. Sue and Sue (2008) also pointed to the roles of the mother in a family system among Asian Americans, among which is to serve and mediate communication within the unit. Troubled Asian Americans typically rely on their mothers to transmit messages to their fathers. Within this context, it is common to see adult Asian immigrants asking for and valuing the opinions of their parents or older siblings and relatives who are still overseas when making important decisions here in the United States.

Taking into account how culture shapes or influences the expression and recognition of various psychological distress, counselors take into account the




family’s worldview and level of acculturation. The case in point is a common dilemma Asian immigrants and their families are facing during family counsel-ing sessions. Because of their hierarchical culture, Asian immigrants may feel uneasy about disclosing their issues in the presence of their children, and the children may feel it is improper to expose their parents’ problems in their pres-ence (Hong & Domokos-Cheng Ham, 2001). Sue and Sue (2008) pointed out that public display of strong emotions are considered to be signs of weakness in terms of maturity or a lack of personal control. Thus, the father may appear peripheral to mainstream American counselors, whereas within the context of Asian cultural milieu, he is properly maintaining his role and position within the unit by remaining authoritative and distant and not appearing to be emotion-ally demonstrative or involved with his children. Sue and Sue (2008) cautioned counselors working with Asian Americans to be careful in using counseling microskills that focus directly on emotions, as it may be uncomfortable and a shame- producing event for traditional Asian Americans. Those emotions can be addressed but in an indirect manner. For example, rather than placing emphasis on the client by saying, “You look troubled,” a more face-saving statement about the generality or the event instead of the person is preferable, such as “This pre-dicament would make anyone troubled.”

Often, the children of Asian immigrants who are raised and educated in the United States are more proficient in and become more identified with main-stream American culture relative to their parents, who tend to have stronger memories and emotional ties to their Asian cultural roots. At the same time, the children are being bombarded with messages from peers, schools, and the mass media championing that Western standards are superior and better than their own. How they adapt to the majority culture and at the same time retain their connection to their culture of origin can produce enough stress within the individual and the family. Okubo, Yeh, Lin, Fujita, and Shea (2007) quoted a scenario in which Asian youths behave in their negotiation and balance their bicultural living by being more “American” outside of their home and being more “Chinese” or “Indian” at home. This dual living can be stressful and exhausting and becomes more important when making critical choices such as future career plans, dating, and marriage (Okubo et al., 2007). Often during counseling ses-sions, these intergenerational mixed with acculturation conflicts play themselves when immigrant youths accuse their parents of being old-fashioned or control-ling, and the parents complain that their children are rebellious or corrupted by the host American culture. This cultural gap creates friction that can be intense enough to lead to family conflicts. These parent–child conflicts are the most common presenting problems for Asian American college students seeking coun-seling (Lee, Su, & Yoshida, 2005; Sue & Sue, 2008). In their study of 8 Chinese American youths with a median age of 16.8 years (SD = 1.36) in New York City




with the number of years in the United States ranging from 1 to 16, Okubo et al. (2007) found that other than cultural values and cultural expectation, Asian youths do consider their individual interests and familial expectations when making career-related decisions. The youths also factored in issues such as maintaining the family reputation, saving face, caring for parents, and respecting elders’ wishes as well as their own goals in their chosen profession.

Asian American children often face greater pressure to succeed academi-cally, and they have more fear of academic failures when compared to their European American counterparts (Sue & Sue, 2008). Schools in Asia are much more structured and regimented with stricter rules and regulations relative to the public schools in the United States. In Asian countries, students are typically required to wear school uniforms. In the classroom, students may stay quiet and listen to teachers. The open discussion format, flexibility, and egalitarian and participatory atmosphere in American public schools could be a source of confusion for Asian American immigrants. Asian American students tend to spend twice as much time each week on academic work compared to non–Asian American students, but they also report feeling isolated, depressed, anxious, and that they receive little or no praise for their accomplishment (Kao, 1995; Sue & Sue, 2008). Asian American parents may have specific career goals in mind for their children, usually in technical fields or hard sciences (Okubo et al., 2007; Sue & Sue, 2008). Often this is merely a reflection on the part of the parents about their expectations and insistence and that they appear to be oblivious to the individual child’s talent or interest. Hong and Domokos-Cheng Ham (2001) pointed out an often-occurring misunderstanding between Asian immi-grant parents and public school teachers centered on the parents’ complaints of their children not having enough homework assigned to them, whereas the teachers advised them not to put too much academic pressure on their children. Asian Americans place high value on education, and the successful performance of their children is viewed as an affirmation and validation of their good parent-ing skills along with an expectation of moving toward achieving higher social status within the community. Thus parents often have high expectations for their children to achieve academically, and from an Asian collectivistic perspec-tive, education of children is also an investment in a family’s future (Hong & Domokos-Cheng Ham, 2001; Sue & Sue, 2008).

Counseling IssuesAsian collectivist tradition does not distinguish the mind and body. It places a premium of maintaining social and familial harmony. Often, the route Asian Americans take toward that end is by discouraging their open display of




emotions and avoiding exposure of personal weakness. Asians Americans are taught to deny the experience and expression of emotions. It is more accept-able to express psychological distress through the body. This cultural attribute contributes to a large amount of expression of somatic symptoms among Asian Americans when compared to White Americans (U.S. Department of Health and Human Services, 2001). In other words, Asian Americans do not necessar-ily suppress or repress affective symptoms, but rather it is the context in which what is being presented and how it is presented. For example, a Chinese client may display somatic symptom such as aches and pains or fatigue to a clini-cian but show depressive symptoms to others. The U.S. Department of Health and Human Services (2001) acknowledged that our present knowledge of the counseling needs of Asian Americans is very limited and that Asian Americans have the lowest rates of utilization of mental health services among ethnic group populations. In a study of 242 Asian American college students at a large mid-Atlantic university and a large university in Hawaii, Kim and Omizo (2003) showed an inverse relationship between adherence to Asian cultural values and attitudes toward seeking professional psychological help. The study also showed the same inverse relationship between adherence to Asian cultural values and willingness to see a counselor. The study by Gloria, Castellanos, Park, and Kim (2008) supported this contention that decreased adherence to cultural values was predictive of increased help-seeking attitudes among second-generation Korean American undergraduates.

Migration experience and adjustment challenge the very structure and organization of the family as a unit. Asian immigrant families may find that their traditional Asian family structure is no longer sustainable in this new adopted land. For example, Asian immigrant children, influenced by the values of mainstream American society, may demand greater autonomy and treat-ment along a continuum ranging from less than hierarchical to egalitarian than culturally permitted in traditional Asia settings. On the other hand, the first-generation Asian immigrants are struggling in their negotiations to balance the past and all those cultural backgrounds and attachments with the pragmatic present. Remember, when the newer generation is asking the older generation to redefine themselves, it touches the core of the individual’s self-identity and hence the presence of a robust energy within each of the holon of the entire system, a dynamic that counselors have to grapple with when providing coun-seling services.

For immigrant couples who have to leave their parents behind in Asia, their inability to care for aging parents may create constant feelings of guilt, especially when they have no other siblings there to assume the responsibility. Some may choose to sponsor their aging parents to immigrate and live with them in the United States. At their advanced age, the older parents often find it difficult to




adjust to the new lifestyle and culture in the United States, and for the couple, the entry of their parents into the nuclear family will change their life patterns. Asian immigrants are not immune to universal issues such as in-laws and gen-eration conflict. Thus, the solution about caring for older parents can be stressful for both the couple and their older parents.

There are family rituals that Asian immigrants are accustomed to, and they face an agonizing dilemma surrounding developmental issues such as births, weddings, and deaths. The rituals as practiced in mainstream American cultures may seem insufficient and inadequate for some Asian Americans, and they are left feeling guilty and despondent over their inability to carry out the full gamut of rituals as they experienced in their native land. They often travel to their home countries to continue and follow up with a more elaborate and “corrected ver-sion” of the rituals. Rituals such as welcoming a newborn or planning a wedding can be postponed, but a funeral has a special urgency and meaning, hence its profound effects on the immigrants. (Hong & Domokos-Cheng Ham, 2001)

Issues for CounselorsEngaging Asian immigrants in counseling poses a unique challenge for coun-selors. Counselors need to become more responsive to a culturally adapted counseling approach when counseling Asian immigrants who tend to retain strong cultural values (Kim et al., 2009; Portland, 2009; Sue & Sue, 2008). The structural approach in counseling Asian immigrants, with its emphasis less on insights but more on behavioral changes and the interventions that focus on a family’s organization and its communication in the present, seems closer to the Asian cultural milieu. Hammond and Nichols (2008) recommended that counselors use a collaborative partnership approach, although seemingly known for its forceful directive interventions, in their attempts to make their interven-tions effective. To be effective when working with immigrant families, coun-selors must develop self-awareness of their own feelings, attitudes, and beliefs about immigrants and working with them (Portland, 2009). Counselors need to be flexible and practical to provide effective interventions that are focused and clear and to learn about their clients and the particulars of the family’s culture in terms of roles, rules, values, and relationships (Portland, 2009; Poulsen, 2009). The goal of the intervention is for the clients to develop new perspectives that will lead them to adopt new actions, not by pushing clients to change but by understanding and affirming them via reaching and motivating them to accept responsibilities for changing their behaviors (Hammond & Nichols, 2008). The prerequisite, according to Hammond and Nichols (2008), is for the counselors




to make active efforts to elicit and acknowledge what their clients think and feel and, at the same time, work as respectful collaborative partners before embark-ing on the tasks of challenging them to change. As helping professionals, coun-selors are working in a constant state of mediating the influences of cultural forces within self, clients, and others, and within this context, they must be proactive in responding to the needed knowledge, awareness, and skills neces-sary to be of service to their clients (Portman, 2009).

From the outset, when a counselor forms an alliance with his or her clients, the goals have always been to free the identified patient of the symptoms, to reduce conflict and stress for the family, and for the family to learn new ways of coping (Minuchin & Fishman, 1981). Counselors must consider the behaviors, values, and priorities relating to other developmental landmarks such as dating practices, marriage, and gender roles in the context of cultural backgrounds of their Asian American clients (Madathil & Sandhu, 2008). At the same time, this subtle process enables the counselor to gather data about the family’s existing hierarchies, values, and norms while affirming and acknowledging each member of the family. In a roundabout way, the joining process is conducive to the Asian cultural milieu, taking into account the Asian immigrant clients’ cultural expec-tations such as the counselor is a professional with expert knowledge and that he or she respects the hierarchical structure of common patriarchal Asian families. The counselor is letting the clients know that he or she understands them and is working with and for them. Generally, these attempts by the counselor to gain acceptance and admission to the family are viewed as congruent with what typi-cal Asian immigrants expect from counseling.

Asian immigrants tend to define their presenting problems in concrete terms, and they expect the counselor, being an expert, to provide them with solu-tions. Coming for counseling treatment may be viewed as bringing shame to the family. Mental and emotional disorders carry a stigma within the community. Guilt and shame within the context of Asian “loss of face” carry a big stick that implies that the entire family is losing respect and status within the community when one of them is shamed. That identified patient is then positioned in an untenable place and is under heavy pressure to keep the harmony and order within the unit by minimizing any conflicts and problems that could shame and bring guilt to the family (Chung et al., 2008; Ho, 1990; Kim et al., 1999; Sue & Sue, 2008). Thus, a counselor needs to carefully balance his or her attempts to identify the problem while appearing to respect the client’s cultural background in a congruent manner. Often, the client’s initial description of the presenting problems may appear to the counselor as one in which the client externalizes the root causes and spends a lot of time complaining and blaming. It is not uncom-mon to hear a client who lost his job to attribute such loss to his wife’s inability




to execute household chores and duties or to attribute their child’s poor school performances on the wife’s spoiling and babying the child too much.

In the context of Asian immigrants’ cultural milieu, the counselor can use the techniques of relabeling, reframing, and therapeutic paradox in his or her attempt to interrupt the sequences of problem-generating behaviors of family members. This attempt is congruent with the concept of “saving face” but is deemed more important in the context of collectivistic, hierarchical family structure of Asian immigrants in which no one in the family is blamed for the sequences of prob-lematic behavior, but instead the expert, in the person of counselor, continues to honor and respect each member of the family by affirming their roles and place in the unit. Counselors need to relabel or reframe the behavioral sequence of the presenting problems to make solutions of the presenting problems appear doable and within the capability and competence of the family. Once the fam-ily buys this, it is easier to move gradually to other issues beyond the presenting problems. The counselor, being accepted as an expert by the clients, can easily encourage the members to interact with each other and with the counselor. The counselor can observe the process through which the presenting problems often emerge. On occasion, the counselor will be called to intensify the current trans-actions to gauge the family’s understanding and acceptance of challenges and the ways they perceive reality. The counselor regulates the transactions in terms of affect, repetition, and duration. Observing interactions within the session is the hallmark of the systemic approach of counseling. Counselors adopting this approach may attempt to shape the competence of the family members in tak-ing care of themselves (without the presenting problem) from the very moment when they meet the family and begin the counseling relationship (Nichols & Schwartz, 2006).

Often, an ability to converse in English can place the family unit in a hier-archical inversion situation, especially when the parents are unable to speak or master the language (e.g., English), and they have to rely on their children to translate, a dynamic that often inverses the traditional hierarchical structure of the family. The parents will find themselves more isolated from mainstream institutions and have to rely on and become dependent on their children to connect to the outside world. This hierarchical inversion can have a destructive effect on the family. Just as it is an awesome task for each of the family members to adjust to the new environment, it is also an equally challenging task for the counselor to formulate effective intervention strategies acceptable to the fam-ily members. It can either make or break the counseling relationship with this family.

Counselors also need to be careful when asking each family member to describe what he or she perceives of the family patterns. Often the response is very much influenced by factors such as whether a family member was born and raised




in Asia or born in the United States. Hong and Domokos-Cheng Ham (2001) illustrated such instances in which the parents, born and raised in Asia, may iden-tify a family pattern of responsibility and sacrifice and hence the discipline (“I did that for your own good,” “It hurts me more than you ever know when I punish you”), a theme consistent with Asian cultural values, whereas the children, born and raised in the United States, may identify the same values by relabeling them as stifling restriction, authoritarian, and perhaps downright abusive.

The transactions within the family may reveal the fact that the children, exposed to the egalitarian concept in the mainstream culture, expected to be asked instead of being told, and the parents may perceive such a request as akin to reducing their position within the familial hierarchy or downgrading their status or perhaps perceive it as an act of teenage rebelliousness, defiance, or downright disrespectfulness. In their attempts to reestablish and maintain such traditional hierarchical structure, and not reduce their stature as parents by acquiescing to the demands of the teenage children, they will continue with the same old family patterns to maintain control, hence perpetuating the homeo-stasis. A keen counselor can detect such scenarios when the observed member starts using the words “demand” or “telling” as opposed to “let’s see” or “ask-ing.” It is incumbent on the counselor to be conscientious in tracking all of these family patterns and in formulating culturally appropriate treatment plans and goals.

When working with recent Asian American families, counselors need to be aware of the within-group diversity and how they relate to the counseling pro-cess. Acculturation issues remain a focus that counselors must assess throughout the counseling sessions.

ReferencesChung, R. C., Bemak, F., Ortiz, D. P., & Sandoval-Perez, P. (2008). Promoting the

mental health of immigrants: A multicultural/social justice perspective. Journal of Counseling and Development, 86, 310–317.

Gloria, A. M., Castellanos, J., Park, Y. S., & Kim, D. (2008). Adherence to Asian cultural values and cultural fit in Korean American undergraduates’ help-seeking attitudes. Journal of Counseling and Development, 86, 419–428.

Hammond, R. T., & Nichols, M. P. (2008). How collaborative is structural family therapy? The Family Journal: Counseling and Therapy for Couples and Families, 16, 118–124.

Ho, C. K. (1990). An analysis of domestic violence in Asian American communities: A multicultural approach to counseling. Women and Therapy, 9, 129–150.

Hong, G. K. & Domokos-Cheng Ham, M. (2001). Psychotherapy and counseling with Asian American clients: A practical guide. Pacific Grove, CA: Sage.




Kao, G. (1995). Asian American as model minorities? A look at their academic perfor-mance. American Journal of Education, 103, 121–159.

Kim, B. S. K., Atkinson, D. R., & Yang, P. H. (1999). The Asian values scale: Development, factor analysis, validation, and reliability. Journal of Counseling Psychology, 46, 342–352.

Kim, B. S. K., Ng, G. F., & Ahn, A. J. (2009). Client adherence to Asian cultural val-ues, common factors in counseling, and session outcome with Asian American cli-ents at a university counseling center. Journal of Counseling and Development, 87, 131–142.

Kim, B. S. K. & Omizo, M. M. (2003). Asian cultural values, attitudes toward seeking professional psychological help, and willingness to see a counselor. The Counseling Psychologist, 31, 343–361.

Kim, B. S. K., Yang, P. H., Atkinson, D. R., Wolfe, M. M., & Hong, S. (2001). Cultural value similarities and differences among Asian American ethnic groups. Cultural Diversity and Ethnic Minority Psychology, 7, 343–361.

Kluger, J. (2009, August 12). Stereotypes persist even where immigrants don’t. Time. Retrieved August 12, 2009, from: http://www.time.com/time/health/arti-cle/0,8599,1915768,00.html

Lee, R. M., Su, J., & Yoshida, E. (2005). Coping with intergenerational family con-flict among Asian American college students. Journal of Counseling Psychology, 47, 211–222.

Liu, L. W. (2009, July 22). California apologizes to Chinese Americans. Time. Retrieved August 12, 2009, from http://www.time.com/time/nation/article/ 0,8599,1911981,00.html

Madathil, J. & Sandhu, D. S. (2008). Infidelity in Asian Indian marriages: Implications for counseling and psychotherapy. The Family Journal: Counseling and Therapy for Couples and Families, 16, 338–343.

Minuchin, S. & Fishman, H. C. (1981). Family therapy techniques. Cambridge, MA: Harvard University Press.

Nichols, M. P. & Schwartz, R. C. (2006). Family counseling: Concepts and methods (7th ed.). Boston, MA: Allyn and Bacon.

Okubo, Y., Yeh, C. J., Lin, P. Y., Fujita, K., & Shea, J. M. (2007). The career decision-making process of Chinese American youth. Journal of Counseling and Development, 85, 440–449.

Portman, T. A. A. (2009). Faces of the future: School counselors as cultural mediators. Journal of Counseling and Development, 87, 21–27.

Poulsen, S. S. (2009). East Indian families raising ABCD adolescents: Cultural and gen-erational challenges. The Family Journal: Counseling and Therapy for Couples and Families, 17, 168–174.

Takaki, R. (1989). Strangers from a different shore: A history of Asian Americans. New York: Little, Brown.

Sue, D. W. & Sue, D. (2008). Counseling the culturally diverse: Theory and practice (5th ed.). Hoboken, NJ: John Wiley & Sons.

U.S. Census Bureau. (2003, May). The Asian and Pacific Islander population in the United States: March 2002; Population characteristics. Retrieved October 14, 2009, from http://www.census.gov/prod/2003pubs/p20-540.pdf


http://www.time.com/time/health/arti-cle/0,8599,1915768,00.html



http://www.time.com/time/nation/article/

http://www.census.gov/prod/2003pubs/p20-540.pdf



U.S. Census Bureau. (2004a, March). Current population survey, annual social and economic supplement, 2004, racial statistics branch, population division. Retrieved October 14, 2009, from http://www.census.gov/population/socdemo/race/api/ppl-184/tab3.pdf

U.S. Census Bureau. (2004b, December). We the People: Asian in the United States [Census 2000 Special Reports]. Retrieved October 14, 2009, from http://www.census.gov/prod/2004pubs/censr-17.pdf

U.S. Department of Health and Human Services, Office of the Surgeon General, SAMHSA. (2001). Culture, race and ethnicity: A supplement to mental health. In Mental care for Asian Americans and Pacific Islanders (pp. 107–126). Rockville, MD: Author. Retrieved October 14, 2009, from http://www.surgeongeneral.gov/library/mentalhealth/cre/sma-01-3613.pdf


http://www.census.gov/population/socdemo/race/api/ppl-184/tab3.pdf

http://www.census.gov/

http://www.surgeongeneral.gov/


Routledge Taylor & Francis Group 270 Madison...

Documents

Transcript of Routledge Taylor & Francis Group 270 Madison...